Neuropsychiatric Disease and Treatment (Feb 2023)
Validation of the THINC-It Tool for Assessment of Cognitive Impairment in Patients with Bipolar Depression
Abstract
Na Zhu,1,* WeiHua Zhang,2,* Jia Huang,3 Yousong Su,3 JingFang Lu,3 Lu Yang,3 YiFan Shi,3 ShaoHua Hu,4,* Jun Chen,3,5,* Yiru Fang3,5,6,* 1Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tong Ji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Psychiatry, Taizhou Second People’s Hospital, Taizhou, People’s Republic of China; 3Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 4Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder Management of Zhejiang Province, Hangzhou, People’s Republic of China; 5Shanghai Key Laboratory of Psychotic Disorders, Shanghai, People’s Republic of China; 6State Key Laboratory of Neuroscience, Shanghai Institutes for Biological Sciences, CAS, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: ShaoHua Hu; Jun Chen, Email [email protected]; [email protected]: Cognitive impairment is one of the core features of bipolar depression. A unified, reliable, and valid assessment tool is key to screening and assessing cognitive impairment. The THINC-Integrated Tool (THINC-it) is a simple and quick battery for screening cognitive impairment in patients with major depressive disorder. However, the use of the tool has not been validated in patients with bipolar depression.Methods: The cognitive functions of 120 patients with bipolar depression and 100 healthy controls were evaluated using the THINC-it tool including Spotter, Symbol Check, Codebreaker, Trials, and the only one subjective test (PDQ-5-D) and five corresponding standard tests. A psychometric analysis of the THINC-it tool was performed.Results: The overall Cronbach’s alpha coefficient of the THINC-it tool was 0.815. The intra-group correlation coefficient (ICC) of retest reliability ranged from 0.571 to 0.854 (P< 0.001), while the correlation r of parallel validity ranged from 0.291 to 0.921 (P< 0.001). There were significant differences in the two groups Z-scores of THINC-it total score, Spotter, Codebreaker, Trails, and PDQ-5-D (P< 0.05). Construct validity was analyzed using exploratory factor analysis (EFA). The Kaiser-Meyer-Olkin (KMO) value was 0.749. Using Bartlett’s Sphericity test, the χ2 (10) value was 198.257 (P< 0.001). The factor loading coefficients of Spotter, Symbol Check, Codebreaker, and Trails on the common factor 1 were − 0.724, 0.748, 0.824, and − 0.717, respectively, and the factor loading coefficient of PDQ-5-D on the common factor 2 was 0.957. Results revealed that the correlation coefficient of the two common factors was 0.125.Conclusion: The THINC-it tool has good reliability and validity in assessing patients with bipolar depression.Keywords: bipolar disorder, cognitive impairment, reliability, THINC-it tool, validity